阻害性睡眠時無呼吸症における外周化学反射感受性の選択的増強

K Narkiewicz¹, P J van de Borne, C A Pesek

¹Cardiovascular Division, Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, USA.

Circulation

|March 9, 1999

まとめ

阻害性睡眠時無呼吸症 (OSA) は化学反射機能を変化させ,低酸素に対する自律的,血液動力学的,呼吸器の反応を高めます. これは,OSA患者の低酸素レベルに対する身体の反応の強化を示唆しています.

科学分野:

心血管生理学心血管の生理学
呼吸器医学とは
スリープ・メディシン (睡眠医学)

背景:

化学反射は,呼吸と自律的な心血管機能の調節に不可欠です.
機能不全の化学反射は,阻害性睡眠時無呼吸症 (OSA) の心血管ストレスに寄与する可能性があります.

研究の目的:

OSA患者の化学反射機能の変化を調査する.
化学反射機能がOSAを有する個体において変化しているという仮説を検証する.

主な方法:

呼吸器,交感器,心拍数,血圧の反応を低酸素,高頭痛,冷血圧検査と比較した.
16人の未治療OSA患者と12人の健康な対照群を評価した.
測定されたベースラインと刺激された筋肉交感神経活動 (MSNA).

主要な成果:

OSAの患者は,対照群と比較して,ベースラインより高いMSNAを示した.
低酸素状態では,OSA患者には,過度の換気,心拍数,血圧の上昇が見られた.
低酸素に対するMSNAの反応は呼吸と類似していたが,低酸素による無呼吸時にOSA患者で強化された.

結論:

阻害性睡眠時無呼吸症は,自律的,血液動力学的,および呼吸器の反応の選択的強化と関連しており,特に低酸素誘発の周辺化学受容体活性化に関連しています.
これらの発見は,OSA患者における特定の化学反射異常,特に低酸素症の課題を強調しています.

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